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LETTER TO THE EDITOR
Year : 2020  |  Volume : 68  |  Issue : 7  |  Page : 1498

Evolving consensus on managing vitreo-retina and uvea practice in post-COVID-19 pandemic era


Sankara Eye Hospital, Varthur Road, Kundalahalli, Bangalore, Karnataka, India

Date of Web Publication25-Jun-2020

Correspondence Address:
Dr. Mahesh P Shanmugam
Sankara Eye Hospital, Varthur Road, Kundalahalli, Bangalore - 560 037, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1704_20

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How to cite this article:
Shanmugam MP, Dubey D, Mishra D, Murali K. Evolving consensus on managing vitreo-retina and uvea practice in post-COVID-19 pandemic era. Indian J Ophthalmol 2020;68:1498

How to cite this URL:
Shanmugam MP, Dubey D, Mishra D, Murali K. Evolving consensus on managing vitreo-retina and uvea practice in post-COVID-19 pandemic era. Indian J Ophthalmol [serial online] 2020 [cited 2020 Jul 14];68:1498. Available from: http://www.ijo.in/text.asp?2020/68/7/1498/287514



Dear Editor:

We read the recent article on the “Evolving consensus on managing vitreo-retina and uvea practices in post COVID-19 pandemic era” with great interest.[1] We wish to highlight the part concerning wrapping of ophthalmic equipment's by Dr. Manisha Agarwal as it was based on our prior experience. We have been using this technique at our hospital for the past few months and would like to elaborate further about our experience.

Doremalen et al.[2] observed that the COVID-19 virus stayed viable on surfaces like plastic and steel as fomites (72-96 hours) for a longer duration than as aerosol (3 h). Respiratory aerosols can easily escape from an ill-fitting/ineffective mask. The close proximity of the patient's nose to the optical coherence tomography (OCT) machine can cause fomites to settle on its front surface and lens. Repeated cleaning of the lens and the sensors of the OCT machine can cause micro-abrasions and leave surface residues. Covering the front part of the machine with a thin plastic sheet or cling-on wrap acts as a barrier to contamination, also protecting the optical surface of the machine from undue damage caused by repeated cleaning.

We observed no significant difference in the image quality obtained with and without the front cover for both OCT and OCT-A [Figure 1] and [Figure 2]a.[3] Thinner and taut (devoid of folds) plastic sheet placed close to the lens provided best image quality. This technique was found to be effective for both SS-OCT (swept source OCT) and SD-OCT (spectral domain OCT).
Figure 1: Picture showing image quality of optical coherence tomography scan with and without the front cover (a and b)

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Figure 2: Optical coherence tomography angiography scan image with the front cover (a). Fundus picture showing the light-flash artifact obtained with the front cover in place (b)

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The cover can be cleaned between examinations with a clean tissue paper and isopropyl alcohol and can easily be replaced when required.

Fundus pictures obtained have a light-flash artifact in the center of the image [Figure 2]b; hence, we do not recommend its use for taking fundus photographs. Machines utilizing lasers to capture image should not have this artifact.

We found this to be an easy, inexpensive, and effective method. Along with preventing the contamination, it also protects the optical system; hence, this modification can be utilized even in the post-COVID-19 era.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Gupta V, Rajendran A, Narayanan R, Chawla S, Kumar A, Palanivelu MS, et al. Evolving consensus on managing vitreo-retina and uvea practice in post-COVID-19 pandemic era. Indian J Ophthalmol 2020;68:962-73.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med 2020;382:1564-7.  Back to cited text no. 2
    
3.
Available from: https://youtu.be/ROyT-Cr20kA. [Last accessed on 2020 Jun 12].  Back to cited text no. 3
    


    Figures

  [Figure 1], [Figure 2]



 

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